EVERYTHING YOU NEED TO KNOW ABOUT AN EPISIOTOMY

What is an episiotomy?

An episiotomy is a simple procedure that may take place during childbirth to allow the baby to come out more easily. In England around 1 in 7 births involve an episiotomy.

To help you understand the procedure and how it works, here’s our lowdown on the episiotomy.  

What happens during an episiotomy?

When you have an episiotomy the midwife or doctor will make a small cut from the vagina, directed down and out to one side (usually the right). A local anaesthetic is uses to numb the area around the vagina so you do not feel any pain. If you have already had an epidural the dose can be topped up before the cut is made. The cut will be stitched together using dissolvable stitches after the birth.

Although fairly common, episiotomies are not routine and you will be asked before anything is done.  

Why might I need an episiotomy?

There are serval reasons why you may need an episiotomy, such as:

• Forceps, or ventouse, are needed to facilitate the birth
• Your baby’s heart rate shows they are distressed, so birth needs to be quick to avoid the risk of birth injuries or stillbirth
• You have a health condition such as a heart problem and it’s recommended that birth should be as quick as possible to reduce further health risks

Does it hurt to go to the toilet after an episiotomy?

It will hurt a bit when you go to the loo. You can try and ease this by pouring warm water over the outer area of your vagina as you wee. Squatting over the toilet – rather than sitting – may also make it less painful.

Having a poo can also hurt as it puts pressure on your stitches. Putting a clean pad on the cut and pressing gently can help with this. If it’s proving really painful to poo, you could try taking a laxative to make it easier.

Always wash your hands both before and after you use the toilet. And after you’ve had a poo, make sure you wipe from the front to back to prevent episiotomy infection. 

How long does it take to recover from an episiotomy?

You can help the episiotomy care and recovery process by resting as much as possible. As a new mum that can be easier said than done, so try and rest when your baby is sleeping.

Episiotomy healing can also be helped by airing your stitches. Do this by taking off your underwear and lying down on a towel on your bed for ten minutes or so each day. In addition, try and do some pelvic floor exercises when you feel able – as this will boost blood circulation to the affected area and help the episiotomy healing process.

You should talk to your doctor or midwife about activities that should be avoided during recovery.

You may feel uncomfortable for two or three weeks after an episiotomy. You can take paracetamol and ibuprofen to help relieve this (but not aspirin if you’re breastfeeding). You can also try wrapping up some ice cubes in a towel, or using an ice pack, and putting it on your cut. Be careful never to put ice directly onto yourself as this can be harmful. 

How long does episiotomy healing take?

Your episiotomy cut will normally be stitched up within an hour of birth. It may bleed quite a lot at first, but that will stop thanks to stitching and pressure. Your stitches will take about a month to dissolve.

An episiotomy scar can sometimes form. If that is causing problems- such as being itchy or particularly prominent – then you should discuss this with your GP.

How soon can I have sex after an episiotomy?

You may feel both sore and tired for a few weeks after birth and it’s very common to feel pain when having sex after an episiotomy. But there are no rules to say when you can – or can’t – have sex after an episiotomy.

That decision is yours alone and you should never feel pressured into it. When you are ready to try again, you must tell your partner if it hurts – don’t feel like you just have to ‘put up with it’. Pain can also be linked to vaginal dryness which is common in the weeks after birth, so you could try a water-based lubricant to help. If vaginal dryness persists and causes you discomfort speak to your GP.